Medicare Advantage

HMO, PPO, PFFS: what the letters mean in Frisco

People in Frisco can choose from 81 Medicare Advantage plans for 2027, against 97 this year. 37 of this year’s plans are gone, 21 are new to Collin County, and 30 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

Medicare AdvantageFrisco, TX

If you live in Frisco and you're weighing a Medicare Advantage plan for 2027, the first thing worth understanding isn't the number of plans on the shelf — it's who's selling them and what kind of plan each one is. Frisco sits in Collin County, and that's the level where Medicare sets plan availability. Twelve carriers are offering Medicare Advantage plans with drug coverage there for 2027, and they come in four different structures: HMO, HMO-POS, PPO and PFFS. Some are also Special Needs Plans built for a specific group of people.

Here's a plain-English guide to who the carriers are, how many plans each one brings, and what the plan-type letters actually mean.

Who sells Medicare Advantage in Collin County

Twelve carriers file Medicare Advantage plans in the county for 2027. Listed alphabetically, they are:

• Aetna (CVS Health) — 9 plans (HMO, PPO; 4 Special Needs)
• American Health Advantage of Texas — 1 plan (HMO; 1 Special Needs)
• Baylor Scott & White Health Plan — 4 plans (HMO-POS, PPO)
• Blue Cross Blue Shield (HCSC) — 17 plans (HMO, PPO; 2 Special Needs)
• Centene (WellCare) — 7 plans (HMO; 4 Special Needs)
• Elevance Health (Anthem) — 6 plans (HMO, HMO-POS; 5 Special Needs)
• Humana — 22 plans (HMO, PFFS, PPO; 6 Special Needs)
• Molina Healthcare of Texas — 1 plan (HMO; 1 Special Needs)
• ProCare Advantage — 3 plans (HMO-POS; 3 Special Needs)
• Provider Partners Health Plans — 1 plan (HMO; 1 Special Needs)
• UnitedHealthcare — 24 plans (HMO-POS, PPO; 10 Special Needs)
• Verda Health Plan of Texas — 2 plans (HMO; 1 Special Needs)

The table below on this page lists every plan by carrier so you can see the full lineup without scrolling through all 97 names here.

The plan-type letters, translated

Every Medicare Advantage plan is built around a network rule. That rule is what the letters after each plan name mean.

HMO (Health Maintenance Organization). You pick a primary care doctor in the plan's network and generally need a referral to see specialists. Care outside the network usually isn't covered except for emergencies. Frisco's lineup includes 37 HMO plans.

HMO-POS (HMO with a Point-of-Service option). Same idea as an HMO, but the plan lets you go outside the network for certain services, typically at a higher cost. Twenty-six plans in the county are HMO-POS.

PPO (Preferred Provider Organization). More flexible. You can see any doctor who accepts Medicare and the plan's terms, in or out of network, though in-network costs are lower. Referrals usually aren't required. Thirty-two plans in the county are PPOs, including a few Regional PPOs (like several HumanaChoice and UHC options) that use a broader multi-state service area.

PFFS (Private Fee-for-Service). The plan decides how much it will pay providers and how much you pay. Providers choose whether to accept the plan's terms on a visit-by-visit basis, so you'll want to confirm each time. Only two plans in the Frisco area — both from Humana — are PFFS.

Special Needs Plans: a different door into Medicare Advantage

Of the 97 plans in Collin County, 38 are Special Needs Plans, or SNPs. These are Medicare Advantage plans you can only join if you fit a specific category. There are three kinds:

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid. Carriers offering D-SNPs in the county include Aetna, Blue Cross Blue Shield, Centene (WellCare), Elevance Health (Anthem), Humana, Molina and UnitedHealthcare.
• C-SNP (Chronic Condition). For people with a qualifying chronic condition such as diabetes, heart disease or end-stage renal disease. Examples in the roster include Aetna Medicare Prime Chronic Total, Humana Gold Plus — Diabetes and Heart, ProCare Advantage's diabetes and kidney care plans, UHC Complete Care C-SNPs, Wellpoint Chronic Care, Wellpoint Kidney Care, and Verda Noble Chronic Care.
• I-SNP (Institutional). For people who live in a nursing home or need that level of care at home. Local examples include American Health Advantage of Texas, Humana Together in Health, ProCare Advantage's I-SNP, Provider Partners Texas Advantage, and UHC Nursing Home Plan.

If you don't qualify for one of these categories, an SNP isn't an option — but that leaves 59 non-SNP plans in the county to consider.

What about a stand-alone drug plan?

All 97 Medicare Advantage plans in Collin County include prescription drug coverage. That's a common pattern in the Medicare Advantage market, and it's why you'll sometimes hear these plans called "MA-PD." If you want prescription coverage without joining a Medicare Advantage plan, you'd normally add a stand-alone Part D plan to Original Medicare. Those are counted separately from the MA-PD lineup shown here.

A few program-level Part D facts for 2027 that apply to whichever route you take:

• The annual out-of-pocket cap on covered Part D drugs is $2,100.
• The maximum Part D deductible a plan can charge is $615.
• The old coverage gap ("donut hole") is gone — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments if you choose.

How to think about the choice

Carrier name and plan type do different jobs. The carrier controls the network of doctors and hospitals, the pharmacy list and the extra benefits. The plan type controls how you're allowed to use that network — whether you need a referral, whether you can go out of network, and what happens when you do.

A useful order of questions:

1. Do my doctors and preferred hospitals take this plan? 2. Are my prescriptions on the plan's drug list, and at what tier? 3. Do I qualify for a Special Needs Plan, and would one fit my situation better? 4. Do I want the tighter structure (and often lower cost-sharing) of an HMO, or the flexibility of a PPO?

None of these questions can be answered from a plan name alone. That's what the Medicare Plan Finder at medicare.gov is built for.

Dates to keep in mind

• October 15 – December 7: Annual Enrollment Period. You can join, switch or drop a Medicare Advantage or Part D plan for coverage starting January 1.
• January 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you get one chance to switch to another Medicare Advantage plan or return to Original Medicare (with a Part D plan if you need drug coverage).